96 Claims Adjuster jobs in South Africa
Claims Processing Manager
Posted 8 days ago
Job Viewed
Job Description
Manage the Benefits Investigation and claims processing function, ensuring the provision of professional support services to the surviving dependents/beneficiaries (for informed allocation of benefits) to the correct beneficiaries in compliance with the Fund rules, Section 37C of the Pension Funds Act and related Acts. Ensure the timeous and accurate payment of benefits, manage issues associated with claims and benefit administration.
Duties & ResponsibilitiesManage internal departmental functions and processes
- Develop and implement plans for the section that support Pension Administration and the company's objectives, ensuring optimisation of current business and workflow processes.
- All benefit processing activities in accordance with the benefits as defined in the rules of the Fund and applicable legislation.
- Unclaimed benefits and Evidence of Survival reviews, tracing and verification.
- Fund valuation and all audits.
- Provide interpretation advice on the application of the Rules of Fund.
- Ensure that audit controls are in place and audit requests are followed up.
- Participate on the defined Committees (Benefits Committee (BC), Medical Panel (MP), Management Benefits Committee (MBC)) and take decisions based on formal documentation.
Project Management
- Participate in the Fund’s overall projects as required with continuous focus on Business Processes, system enhancements, omni channel business insight, contributing expertise to enable project objectives to be met.
- Draft reports as part of the project deliverables.
Provide input to the strategic management of the section
- Contribute ideas for improved service delivery at Management meetings.
- Compile comprehensive business reports for this function, highlighting successes and risks in terms of achieving the section’s objectives.
- Keep abreast with changes in relevant guidelines and other legislation, to make recommendations where policies and procedures need to be amended.
Oversee Section 37C dependency investigations on death benefits allocations
- Manage investigations on death benefit cases confirming dependency with recommended benefits allocation percentages for approval by Benefits Committee.
- Monitor that outstanding banking details for payment of approved death benefits are followed up, and confirmed.
- Verify that death benefits allocation reports produced are legally compliant with recommendations and reflect minimal errors.
Oversee the provision of social services to guardian cases; implementation of Benefits Committee & Medical Panel decisions and requests / referrals for case investigations and social advice from other internal departments
- Implementation of decisions, requests and referred cases, with reports and recommendations being submitted to BC, MP& BP or other internal departments.
- Ensure compliance with Fund rules and legislation to suspension, addition, termination and reinstatement of beneficiaries (widows and minor children) in compliance.
Financial Management
- Forecast annual capital and operational expenses for the section in line with corporate policy.
- Manage costs against approved budget.
- Investigate methods to contain / reduce costs.
Corporate Governance
- Ensure compliance to procedures and relevant legislation.
- Provide detailed, accurate information for internal and external audit purposes within specified deadlines.
- Action audit issues identified within time frames indicated.
- Implement controls within the section which minimize potential risk to stakeholders.
REQUIRED MINIMUM WORK EXPERIENCE AND QUALIFICATIONS
- Relevant Bachelor’s Degree, preferably in Law. Registered with professional bodies - where applicable.
- At least 6 years job-related experience, which should include at least 2 years’ experience in a management role.
- Knowledge of an African Language is an advantage.
- Working knowledge of Pension Fund Rules.
- Basic knowledge of Income Tax Act, Divorce Act, Pension Funds Act, Child Care Act, Marriage Act, Recognition of Customary Marriage Act, Mental Health Act.
- Working knowledge of Benefit administration.
- Knowledge of Law - Section 37 (C) allocation of death benefit lump sums.
- Valid driver’s license.
Should you meet the above requirements, please upload your CV to our website CVs VIA EMAIL WILL NOT BE CONSIDERED.
All suitably qualified candidates are encouraged to apply and will be considered. Our client applies the principles of employment equity as per National legislation and policy guidelines and will consider designated groups in line with these requirements.
Full spec to be shared with shortlisted candidates. Shortlisted candidates will be required to go through background screening and assessments.
Package & RemunerationR - R - Annually
- HR Services, Recruitment & Selection
Team Lead: Claims Processing
Posted today
Job Viewed
Job Description
Join TIH, home to some of South Africa's leading financial service providers, and grow your career while being part of an organisation with purpose.
Job Purpose
Lead a team of Processing Claims Consultants to ensure the effective validation of already-captured claims. Ensure individual contributors are performing against targets, while reviewing their performance and coaching them to do so in order to assist in achieving the required operational targets.
Responsibilities
Leadership and Direction
Explain the local action plan to support team members in their understanding of what needs to be done and and how this relates to the broader business plan and the organisation's strategy, mission and vision; motivate people to achieve local business goals.
Performance Management
Respond to personal objectives and use performance management systems to improve personal performance. Monitor the performance of the team; allocate work and review completion, take appropriate corrective action to ensure timeliness and quality; contribute to formal individual performance management and appraisal.
Operations Management
Supervise others working within established operational systems by ensuring quality decisions are made regarding the outcome of claims.
Operational Compliance
Identify, within the team, instances of non-compliance with the organisation's policies and procedures and/or relevant regulatory codes and codes of conduct, reporting these and escalating issues as appropriate.
Data Collection & Analysis
Collate and analyse claims processing data using pre-set tools, methods and formats. Involves working independently. This may involve identifying trends regarding the customer experience.
Customer Management (Internal)
Help senior colleagues manage client and customer relationships by using relevant client systems.
Document Management
Create and ensure compliance with a company wide document management system.
Administration
Produce, update and provide best practice support on a wide range of MS documents, databases and other departmental systems to support the work of more senior colleagues.
Correspondence
Respond to escalated requests using telephonic conversation or emails (internal and external).
Education
Grade 12/ SAQA Accredited Equivalent (Essential); FAIS Regulatory Qualification (Essential); RE 5 (Essential); Relevant 3 year Business or insurance industry related degree / diploma in management (Advantageous); Class of Business Certification (Essential); STI Qualification (Essential); RE 1 (Advantageous)
Experience
3 or more years Financial Services industry experience within a call centre environment (Essential); STI experience (Essential); 2 or more years Claims Experience (Essential);. 1 or more years experience of supervising and directing people and other resources to achieve specific end results (Essential)
Think you have what it takes to be part of an unstoppable team who constantly finds better ways to give peace of mind? Don't wait, apply now.
Team Lead: Claims Processing - Nedbank
Posted 10 days ago
Job Viewed
Job Description
Overview
Lead a team of Processing Claims Consultants to ensure the effective validation of already-captured claims. Ensure individual contributors are performing against targets, while reviewing their performance and coaching them to assist in achieving the required operational targets.
Responsibilities- Leadership and Direction: Explain the local action plan to support team members in their understanding of what needs to be done and how this relates to the broader business plan and the organisation's strategy, mission and vision; motivate people to achieve local business goals.
- Performance Management: Respond to personal objectives and use performance management systems to improve personal performance. Monitor the performance of the team; allocate work and review completion, take appropriate corrective action to ensure timeliness and quality; contribute to formal individual performance management and appraisal.
- Operations Management: Supervise others working within established operational systems by ensuring quality decisions are made regarding the outcome of claims.
- Operational Compliance: Identify within the team instances of non-compliance with the organisation's policies and procedures and/or relevant regulatory codes and codes of conduct, reporting these and escalating issues as appropriate.
- Data Collection & Analysis: Collate and analyse claims processing data using pre-set tools, methods and formats. Involves working independently. This may involve identifying trends regarding the customer experience.
- Customer Management (Internal): Help senior colleagues manage client and customer relationships by using relevant client systems.
- Document Management: Create and ensure compliance with a company wide document management system.
- Administration: Produce, update and provide best practice support on a wide range of MS documents, databases and other departmental systems to support the work of more senior colleagues.
- Correspondence: Respond to escalated requests using telephonic conversation or emails (internal and external).
- Grade 12/ SAQA Accredited Equivalent (Essential)
- FAIS Regulatory Qualification (Essential)
- RE 5 (Essential)
- Relevant 3 year Business or insurance industry related degree / diploma in management (Advantageous)
- Class of Business Certification (Essential)
- STI Qualification (Essential)
- RE 1 (Advantageous)
- 3 or more years Financial Services industry experience within a call centre environment (Essential)
- STI experience (Essential)
- 2 or more years Claims Experience (Essential)
- 1 or more years experience of supervising and directing people and other resources to achieve specific end results (Essential)
- Mid-Senior level
- Full-time
- Finance and Sales
- Insurance
Johannesburg, Gauteng, South Africa
#J-18808-LjbffrTeam lead: claims processing - nedbank
Posted today
Job Viewed
Job Description
Insurance Claims Consultant
Posted 1 day ago
Job Viewed
Job Description
Insurance: Claims Consultant - POS25208
Based: Roodepoort
Salary: R160,000 and R200,000 CTC + Performance based bonus
We are seeking a highly intelligent, detail-oriented, and resilient individual to join our clients Claims Services team. This role involves managing the full claims process for short-term insurance clients, ensuring accuracy, fairness, and excellent customer service throughout. The ideal candidate thrives in a competitive environment, works well under pressure, and has outstanding interpersonal skills.
Minimum Requirements:
- Matric with an A-grade average (especially in Mathematics)
- BA or BCom degree
- Exceptional attention to detail and analytical skills
- Strong interpersonal and communication skills
- Ability to work effectively in a competitive and fast-paced environment
- Hands-on approach with a proactive attitude
- Strong, confident personality
Key Responsibilities:
- Administer and open new claim files
- Manage day-to-day processing and follow-up of claims
- Appoint and authorise assessors where required
- Direct claims data entry and management on internal systems
- Ensure all controls are in place for valid claim settlements
- Manage repudiations with fairness and professional communication
- Apply policy terms and conditions accurately and consistently
- Contribute to ad hoc projects as required
Closing Date: 31 October 2025
How to Apply
If you meet the above criteria and are ready to take your hospitality career to the next level, please send your updated CV to
Insurance Claims Manager
Posted today
Job Viewed
Job Description
- Application Deadline: 5 November 2025
- Job Location: Johannesburg, Gauteng
- Job Title: Insurance Claims Manager
- Education Level: Certificate
- Job Level: Management
- Minimum Experience: Years
We are looking for a dynamic, hands-on Head of Claims with 6–10 years' experience in the short-term insurance industry, the majority of which should be within the claims environment.
You'll bring both leadership and operational depth — someone who can drive strategy and lead teams, but who also understands the nuances of claims workflows, client service, and insurer engagement.
This is a role for someone who thrives in a fast-paced, empowered environment — someone who can make decisions, solve problems, and constantly challenge the status quo to make our claims experience best-in-class.
Salary on offer: Negotiable based on experience.
Duties and Responsibilities:
- Leadership & Strategy
- Lead and manage the entire Claims Department across all lines of business.
- Develop and execute claims strategies aligned with company growth and service goals.
- Empower, mentor, and hold your team accountable for performance and client outcomes.
- Drive innovation and continuous improvement in claims processes and customer experience.
- Operational Excellence
- Oversee front-end claims management and ensure efficient turnaround times.
- Identify process gaps and implement practical, measurable solutions.
- Maintain strong relationships with insurer partners, assessors, and service providers.
- Ensure claims compliance with all binder and regulatory obligations.
- Culture & Collaboration
- Actively contribute to the leadership team — challenging and supporting where needed.
- Foster a positive, high-performance culture that reflects Bsure's values of empowerment, integrity, and accountability.
- Be proactive in suggesting restructuring, process improvements, or new initiatives that drive better outcomes for clients and teams.
- Performance & Reporting
- Monitor and manage claims ratios, turnaround times, and customer satisfaction metrics.
- Provide data-driven insight and recommendations to the executive team.
- Ensure operational reporting and performance tracking is accurate, clear, and actionable.
Requirements:
- 6–10 Years' experience in short-term insurance, with a significant portion in claims.
- Proven leadership or management experience within a claims environment.
- Strong understanding of insurer relationships, binder structures, and compliance requirements.
- Excellent communication, problem-solving, and decision-making skills.
- Able to operate autonomously while collaborating across multiple departments.
- Driven, accountable, and motivated by results and continuous improvement.
Insurance Claims Manager
Posted today
Job Viewed
Job Description
Bsure Insurance Advisors is one of South Africa's most progressive and people-centric brokerages. We partner with a multitude of insurers and handle key binder functions across underwriting, claims management, and renewals — all while maintaining an obsessive focus on service, empowerment, and culture.
We don't micromanage. We believe in accountability, execution, and ownership. Our leaders operate with autonomy and integrity, constantly looking for better ways to structure, improve, and evolve the business.
We are looking for a dynamic, hands-on Head of Claims with 6–10 years' experience in the short-term insurance industry, the majority of which should be within the claims environment. You'll bring both leadership and operational depth — someone who can drive strategy and lead teams, but who also understands the nuances of claims workflows, client service, and insurer engagement.
This is a role for someone who thrives in a fast-paced, empowered environment — someone who can make decisions, solve problems, and constantly challenge the status quo to make our claims experience best-in-class.
Key Responsibilities
Leadership & Strategy
• Lead and manage the entire Claims Department across all lines of business.
• Develop and execute claims strategies aligned with company growth and service goals.
• Empower, mentor, and hold your team accountable for performance and client outcomes.
• Drive innovation and continuous improvement in claims processes and customer experience.
Operational Excellence
• Oversee front-end claims management and ensure efficient turnaround times.
• Identify process gaps and implement practical, measurable solutions.
• Maintain strong relationships with insurer partners, assessors, and service providers.
• Ensure claims compliance with all binder and regulatory obligations.
Culture & Collaboration
• Actively contribute to the leadership team — challenging and supporting where needed.
• Foster a positive, high-performance culture that reflects Bsure's values of empowerment, integrity, and accountability.
• Be proactive in suggesting restructuring, process improvements, or new initiatives that drive better outcomes for clients and teams.
Performance & Reporting
• Monitor and manage claims ratios, turnaround times, and customer satisfaction metrics.
• Provide data-driven insight and recommendations to the executive team.
• Ensure operational reporting and performance tracking is accurate, clear, and actionable.
⸻
Requirements
• 6–10 years' experience in short-term insurance, with a significant portion in claims.
• Proven leadership or management experience within a claims environment.
• Strong understanding of insurer relationships, binder structures, and compliance requirements.
• Excellent communication, problem-solving, and decision-making skills.
• Able to operate autonomously while collaborating across multiple departments.
• Driven, accountable, and motivated by results and continuous improvement.
⸻
Who You Are
• Dynamic, decisive, and take ownership of outcomes.
• You don't need to be micromanaged — you manage your space, your people, and your results.
• Thrive in a culture that values empowerment, execution, and personal accountability.
• Love working with people, solving problems, and finding better ways to do things.
• Understand that leadership means both guarding and growing your team.
⸻
Why Bsure
At Bsure, our people are the priority.
We work hard, grow fast, and build together. You'll be joining a culture that believes in genuine empowerment, high accountability, and mutual respect — all in a team that's constantly expanding its footprint in the short-term insurance space.
Be The First To Know
About the latest Claims adjuster Jobs in South Africa !
Insurance Claims Consultant
Posted today
Job Viewed
Job Description
Motor Insurance Claims Consultant
Posted today
Job Viewed
Job Description
Remuneration: market-related Location: George Job level: Junior/Mid Type: Permanent Reference: #BH-402 Company: Badger Holdings
Job Description
Motor Claims Consultant – George, South Africa
Join Pacific International Insurance – Where Compassion Meets Excellence
Pacific International Insurance is an Australian-based company, proudly serving customers in Australia and New Zealand through our flagship brand, PD Insurance. We specialise in pet and motor insurance, and we’re excited to be expanding our South African branch!
We’re on the lookout for a service-driven, empathetic, and proactive Motor Claims Consultant to join our growing team in George. If you’re passionate about helping people and thrive in a fast-paced, customer-focused environment, we’d love to hear from you!
Why This Role Matters- Monday to Friday: 00h00 – 08h00 AM (these hours are subject to change and rotational shifts may be applied to support the requirements of the business). These hours align with our Australian clients, giving you more flexibility during your day.
Location: George, South Africa (on-site)
Be part of a global team with a local heartbeat.
Ready to make a difference in people’s lives while growing your career?
Apply now and become part of a company that values compassion, collaboration, and continuous improvement.
What We’re Looking For- Grade 12 / National Senior Certificate.
- Excellent written and verbal communication in English.
- Excellent computer skills.
- Previous experience in a customer service role.
- Strong attention to detail, organisational and admin skills.
- Willingness to work nightshift hours.
- Experience in insurance claims or financial services.
- Strong negotiation, persuasion, and investigative abilities.
- Excellent interpersonal skills and ability to build rapport.
- Skilled in asking probing questions to gather detailed information.
Motor Insurance Claims Consultant
Posted today
Job Viewed
Job Description
Overview
Join to apply for the Motor Insurance Claims Consultant role at Badger Holdings Inc .
We’re on the lookout for a service-driven, empathetic, and proactive Motor Claims Consultant to join our growing team in George, South Africa. If you’re passionate about helping people and thrive in a fast-paced, customer-focused environment, we’d love to hear from you!
Why This Role MattersAs a Motor Claims Consultant, you’ll play a key role in ensuring claims are processed accurately, efficiently, and compassionately. You’ll help manage claims costs in line with policy guidelines, industry regulations, and delegated authorities. Most importantly, you’ll be the voice of our Soft Landings philosophy, delivering exceptional customer service from claim lodgement to closure.
Working Hours- Monday to Friday: 00h00 – 08h00 AM (these hours are subject to change and rotational shifts may be applied to support the requirements of the business). These hours align with our Australian clients, giving you more flexibility during your day.
George, South Africa (on-site)
Be part of a global team with a local heartbeat.
Seniority level- Entry level
- Full-time
- Finance and Sales
- Insurance